Fig. 8. A 68-year-old female patient with medial ankle osteoarthritis (OA) underwent supramalleolar osteotomy (SMO). (A) Preoperative anteroposterior view of the ankle showing medial gutter OA with Takakura stage IIIA. (B) Postoperative 1-year radiograph showing realignment with improvement to stage II. (C) Postoperative 2-year radiograph. (D) Full exposure of the medial talar subchondral bone before the SMO (grade 4). (E) Regeneration of the talar dome articular cartilage at 12 months after SMO (grade 2).